Lorenc Beata, Sikorska Katarzyna, Stalke Piotr, Bielawski Krzysztof, Ziętkowski Dominik
Pomeranian Center of Infectious Diseases, Gdansk, Poland.
Department of Tropical Medicine and Epidemiology, Medical University of Gdansk, Poland.
Clin Exp Hepatol. 2017 Mar;3(1):23-27. doi: 10.5114/ceh.2017.65500. Epub 2017 Jan 30.
Coinfection with hepatitis D virus (HDV) in chronic hepatitis B is associated with more rapid progression to liver cirrhosis. We present two cases of infection with hepatitis D, B and C viruses. Both male patients were primarily diagnosed as infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), HBsAg-positive and anti-HCV-positive. The first patient was treated with interferon, lamivudine and pegylated interferon. A full virological and biochemical response was achieved. The second patient was treated with interferon and ribavirin, lamivudine and twice with pegylated interferon. In the ultrasound elastography progression of liver fibrosis to F4 was described. HDV infection should be considered in patients with HBV minireplication, high activity of aminotransferases and progression of liver disease despite a good virological response to anti-HBV treatment. Efficacy of interferon in HDV infection is severely limited.
慢性乙型肝炎患者合并丁型肝炎病毒（HDV）感染与肝硬化进展更快有关。我们报告了两例丁型、乙型和丙型肝炎病毒合并感染的病例。两名男性患者最初均被诊断为感染乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV），HBsAg阳性且抗-HCV阳性。第一名患者接受了干扰素、拉米夫定和聚乙二醇化干扰素治疗，实现了完全病毒学和生化应答。第二名患者接受了干扰素和利巴韦林、拉米夫定治疗，并两次接受聚乙二醇化干扰素治疗。超声弹性成像显示肝纤维化进展至F4期。对于HBV低水平复制、氨基转移酶活性高且尽管抗HBV治疗有良好病毒学应答但仍有肝病进展的患者，应考虑HDV感染。干扰素治疗HDV感染的疗效严重受限。
